Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 20697 | NE |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 20697 | NE |
NPI | 1366555369 |
---|---|
Provider Name | Dr. Paige S Charleston |
First Address | Omaha, NE 68103-0755 |
Second Address | Elkhorn, NE 68022-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10026301600 | (05) | NE |
1366555369 | (05) | IA |
47069731799 | (05) | NE |